Saturday, February 13, 2016

Doctors’ E-Mail Reminders Help Keep People More Engaged in Their Health Care

Doctors' follow-up emails to patients keep people engaged in health care
Newswise, February 13, 2016 — Research led by UCLA professor on ‘OpenNotes’ model finds that follow-up emails are critical to keeping patients in the know

A study led by Dr. John Mafi, a professor at the David Geffen School of Medicine at UCLA, has found that a simple note from a primary care doctor can be a critical way to keep patients involved in their own health care.

The research, published today in the peer-reviewed Journal of the American Medical Informatics Association, examined a growing national program that provides patients with easy online access to their doctors’ notes about their appointments.

The program, OpenNotes, began in 2010, when 105 primary care physicians invited nearly 14,000 of their patients to view their electronic notes about their clinic visits.

The initiative was intended to better engage patients in their own care and improve communication between patients and their doctors.

It turned out to be quite a success: Patients demonstrated better recall of their medical plans, felt more in control of their care and were more likely to take their medications.

Doctors found that sharing their notes with patients had little negative impact on their workflow. Five years later, more than 5 million patients are participating in the OpenNotes movement.

And recently, four nonprofits contributed a total of $10 million to expand the program to 50 million patients.

But even as the program began to grow, two major questions arose: Would patients continue to access the notes after the initial enthusiasm died down?

And, how important were the doctors’ reminders in prompting patients to remain active participants in their own care?

The study suggests that the reminders are indeed very important.

Led by Mafi, an assistant professor of medicine in the division of general internal medicine and health services research at the Geffen School, the researchers found that patients tended to view clinic notes substantially less once they stopped receiving the reminders, while patients who continued receiving them tended to continue accessing the notes.

Mafi said patients immediately forget between 40 percent and 80 percent of what their doctors tell them — and they get about half of what they do remember wrong.

“Poor patient–doctor communication represents one of the biggest problems in our health care system,” said Mafi, who conducted the research as a fellow in general internal medicine at Boston’s Beth Israel Deaconess Medical Center and Harvard Medical School.

“OpenNotes offers patients a way to remember their doctors’ instructions, rationale for their care plan and any other critical information about their health. OpenNotes has the potential to empower patients to take charge of their health.”

Another recent study about OpenNotes found that patients who read their notes are more likely to take the medicine they need to lower their cholesterol.

The team led by Mafi studied 14,000 patients at Beth Israel Deaconess and at Geisinger Health System in Danville, Pennsylvania, for two years. Doctors at Beth Israel Deaconess sent reminders throughout the study; those at Geisinger stopped after one year.

During the first 12 months, 53.7 percent of the patients at Beth Israel Deaconess and 60.9 percent of the patients at Geisinger checked their doctors’ notes within 30 days of their becoming available to them. Those percentages stayed consistent throughout the year.
During the second year, patients at Beth Israel Deaconess viewed their notes with the same frequency until a slight decline during the final three months.

At Geisinger, however, just 13.2 percent of patients continued viewing their notes once the email reminders ceased.

The study also found that compared to 55.1 percent of white patients viewed their notes, compared with 36.3 percent of black patients; these differences remained relatively consistent even after the researchers accounted for differences in demographics, the patients’ illnesses and other factors.

“While we predicted that reminders would influence patients’ viewing their doctors’ notes, we did not anticipate the large role that reminders seem to play in patients continuing to access viewing their notes,” Mafi said.

“The key lessons of our study are that sending reminders to patients to view their medical notes may be essential to promoting patient engagement and improving patient-doctor communication, and that new health technology implementation requires additional efforts to reduce potential disparities in health.”
Mafi said future studies should evaluate how to better engage non-white patients in order to help mitigate racial and ethnic health disparities.

Researchers should also evaluate the best way to invite patients to view their doctors’ notes and then gauge the impact on patient engagement, management of chronic diseases and health outcomes.

He also added that many patients already have access to their notes but might not realize it.

“We encourage people to ask their doctors or other healthcare professionals about whether they have access to their notes, and to make it a habit to view them,” he said.

The study’s co-authors are Roanne Mejilla, Henry Feldman, Long Ngo, Tom Delbanco, Christina Wee and Jan Walker of Beth Israel Deaconess Medical Center, and Jonathan Darer of Geisinger Health System.
The work was supported by a National Research Service Award training grant (T32HP12706) from the U.S. Health Services and Research Administration and the Ryoichi Sasakawa Fellowship Fund, the National Institutes of Health (K24DK087932); the Robert Wood Johnson Foundation (65921), the Drane Family Fund and the Richard and Florence Koplow Charitable Foundation

Friday, February 5, 2016

New Online Tool Allows Patients to Make Informed Cardiac Care Decisions

MedStar Heart & Vascular Institute Participates in Find Your Heart a Home in Partnership with American College of Cardiology

New Find Your Heart a Home empowers patients in cardiac care
Newswise February 5, 2016– MedStar Heart & Vascular Institute at MedStar Washington Hospital Center is one of only two hospitals in the nation selected to partner with the American College of Cardiology (ACC) on the Find Your Heart a Home™ pilot program, a campaign aimed at empowering patients when making their heart care decisions. Through its participation,

MedStar Heart & Vascular Institute is further demonstrating its dedication to quality improvement, transparency, and patient and provider engagement.

In this era of health care transparency, patients and their families want access to credible information about quality of care to help them make informed decisions.

Consumers consult online search tools to make decisions on restaurants and hotels, and now they can do the same for their cardiovascular care.

Find Your Heart a Home is a first-of-its-kind hospital comparison database for cardiac care. It allows patients and caregivers, to search and compare hospitals based on the cardiac services they provide and important information on the quality of care they deliver.

“Transparency in health care is a growing expectation among patients and their caregivers,” said Allen J. Taylor, MD, FACC FAHA, chief of Cardiology at MedStar Heart & Vascular Institute.

“The Find Your Heart a Home tool can offer the transparency patients are seeking and help eliminate the information clutter by giving them reliable information they need to make informed choices. We are proud to be partnering with ACC on this important pilot project.”

Find Your Heart a Home is populated with data from the National Cardiovascular Data Registry, which tracks certain heart care procedures performed at hospitals nationwide.

 It rated MedStar Washington Hospital Center, the founding hospital of MedStar Heart & Vascular Institute, based on 1,810 cardiac catheterization and angioplasty procedures, and 520 implanted cardiac defibrillators. For each aspect of care evaluated, the Hospital Center’s performance earned the maximum four stars.

The tool is part of ACC’s CardioSmart initiative, a website full of educational information and tools to help guide patients on their heart health journey.

“MedStar Heart & Vascular Institute is a pioneer in this effort to give patients the tools they need to become an active participant when mapping out their cardiac care plan,” said ACC President Kim Allan Williams, MD, FACC. “They are showing a true commitment to transparency and quality and serving as an example to hospitals across the country.”

MedStar Washington Hospital Center’s heart data can be found here, or visit

Monday, February 1, 2016

When Loved Ones Battle Cancer, Families Head to Web for Information More Than Support

Newswise, February 1, 2016 – Loved ones of cancer patients are likely to search for further information about the disease online but less inclined to seek emotional support from social media forums, according to a University of Georgia study published recently in the journal Computers, Informatics, Nursing.

Individuals frequently suffer negative psychological and emotional effects when the people they care about are diagnosed with cancer. It is fairly common for loved ones of cancer patients to develop depression or anxiety disorders as a result of the diagnosis, but there aren’t many studies focusing specifically on cancer patients’ caregivers and family members, said the study’s author, Carolyn Lauckner.

“I think sometimes the loved ones and caregivers get forgotten about,” she said. “And that’s why I wanted to research this population to see if there are ways that we can better support these individuals.”

Lauckner, an assistant professor in the College of Public Health’s department of health promotion and behavior, surveyed 191 people whose loved ones were diagnosed with cancer in the past year or who were currently acting as caregivers to someone with cancer.

The motivation behind the research was personal for Lauckner.

“I went through a period of time where I had three loved ones diagnosed within a short amount of time,” she said. “I had these experiences where I heard about the diagnosis and I would go online to look it up, and then I would immediately become terrified and freak out about all the stuff I read online.”

More than three-quarters of participants searched online for information on a loved one’s disease. Most looked for treatment options, prevention strategies and risk factors, and prognosis information.

“I was pleasantly surprised by the amount of people who said that they were looking for prevention information online and detection information because that shows that not only are they concerned for their loved one but they’re also concerned about how they themselves can avoid cancer, which from a public health perspective is great,” Lauckner said.

Respondents were less inclined to view blogs or go online to hear about others’ cancer experiences. These kinds of sites were linked to negative emotions for participants, such as fear, sadness and anger.

“A lot of people, especially in the cancer realm, they will use blogs or discussion posts to vent and to talk about the harsh realities of living with an illness,” she said.

“And while I think that that is beneficial for both the person who is writing it and potentially for some people who want an idea of what to expect, when someone is dealing with the prospect of their loved one having to go through that experience, it can be extremely distressing.

“You’re only getting a snapshot of what that person’s cancer experience was like, and you may be seeing the snapshot of the worst day that they had” on blogs and discussion boards.

The most commonly visited websites were those of charitable organizations like the American Cancer Society, which were associated with positive emotions. Lauckner said she found this information encouraging because it shows that the participants were consulting reliable sources of information and not being swayed by personal accounts as much.

Lauckner ultimately wants to build on the information gleaned in this study to determine the most effective use of social media and technology to distribute cancer prevention and risk reduction messages to the public.

The study, “The Effects of Viewing and Preferences for Online Cancer Information Among Patients’ Loved Ones,” is available online at

The study received funding from an internal research grant from Michigan State University’s College of Communication Arts and Sciences.