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An Interactive Preventive Health Record (IPHR) to Promote Patient-Centered Preventive Care

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT00589173
Recruitment Status : Completed
First Posted : January 9, 2008
Last Update Posted : July 24, 2012
Agency for Healthcare Research and Quality (AHRQ)
Information provided by (Responsible Party):
Virginia Commonwealth University

Brief Summary:
Americans only receive 50% of indicated preventive services. We hypothesize that an interactive preventive health record (IPHR) will increase the delivery of recommended screening tests, immunizations, and counseling. The IPHR will function as a highly sophisticated personal health record for prevention, linking patients directly to their health information in the electronic record of their primary care physician. The functions of the IPHR will extend beyond those of personal health records by providing tailored recommendations, links to educational resources and decision aids, and patient and clinician reminders. Year one will focus on updating and refining an existing IPHR prototype. The second and third year, through a randomized controlled trial, will examine the effectiveness of the IPHR. Outcomes will include (1) whether the IPHR increases the delivery of recommended preventive services, (2) whether participants use the IPHR, and (3) whether the IPHR increases shared decision-making and improves clinician-patient communication. The study will take place in seven primary care practices in the Virginia Ambulatory Care Outcomes Network (ACORN) that utilize a common electronic medical record (EMR). A randomly selected sample of 5,500 of the practices' 228,000 patients, stratified by age and gender, will be assigned in a one-to-one ratio to receive a request from their clinician to use the IPHR (intervention group) or receive "usual" preventive care (control group). A Preventive Services Survey, which uses standardized questions to evaluate the delivery of preventive care, will be mailed to 4,500 patients and the CAHPS Clinician & Group Survey will be mailed to 1,000 patients. Surveys will be mailed pre-intervention, 6 month post-intervention, and 18 months post-intervention. Delivery of preventive care will be measured by the Preventive Services Survey and EMR data, while shared decision-making and clinician-patient communication will be measured by the CAHPS survey. The change from baseline to 6 and 18 months post-intervention for the control and intervention groups will be compared.

Condition or disease Intervention/treatment Phase
Prevention Behavioral: Interactive Preventive Health Record (IPHR) Behavioral: "Standard" preventive care Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 5500 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: An Interactive Preventive Health Record (IPHR) to Promote Patient-Centered Preventive Care
Study Start Date : September 2007
Actual Primary Completion Date : June 2011
Actual Study Completion Date : June 2011

Arm Intervention/treatment
Experimental: Intervention
Patients referred to the IPHR
Behavioral: Interactive Preventive Health Record (IPHR)
Preventive health record designed to a) show patients the status of their preventive care recorded in their electronic record and b) make recommendations on what USPSTF endorsed preventive services that the user needs to receive.

Active Comparator: Control
Patients receiving "standard" preventive care
Behavioral: "Standard" preventive care
Existing mechanisim for receiving preventive care in primary care (i.e. patients not referred to the IPHR).

Primary Outcome Measures :
  1. The proportion of control and intervention subjects who are current on EACH individual indicated preventive service [ Time Frame: Annual for three years ]
  2. The proportion of control and intervention subjects who are current on ALL indicated preventive services [ Time Frame: Annual for three years ]
  3. The mean score for intervention and control subjects for quality of clinician communication (CAPHS-CGS questions 14-20); and frequency with which patients report sharing medical decisions (CAHPS questions SD 1-3) [ Time Frame: Annual for three years ]

Secondary Outcome Measures :
  1. The proportion of intervention subjects who visit the IPHR and establish an account [ Time Frame: During enrollment period ]

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • All adult patients seen in the study practices within the previous year

Exclusion Criteria:

  • Age <18 years
  • Age >75 years

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00589173

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United States, Virginia
Fairfax Family Practice Centers
Fairfax, Virginia, United States, 22033
Sponsors and Collaborators
Virginia Commonwealth University
Agency for Healthcare Research and Quality (AHRQ)
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Principal Investigator: Alex H Krist, MD MPH Virginia Commonwealth University
Additional Information:
Publications of Results:
Other Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Virginia Commonwealth University
ClinicalTrials.gov Identifier: NCT00589173    
Other Study ID Numbers: PD300045
First Posted: January 9, 2008    Key Record Dates
Last Update Posted: July 24, 2012
Last Verified: July 2012
Keywords provided by Virginia Commonwealth University:
Preventive Care
Health information technology
Personal health record