Toward a More Informed Patient: Bridging Health Care Information through an Interactive Communication Portal*

Article excerpt

INTRODUCTION

Patient access to health information and personal health records is becoming increasingly important in today's healthcare society. With eight out of ten online users searching for medical information, patients seek to be informed in matters of health [1]. In parallel with this high demand, the Institute of Medicine's Crossing the Quality Chasm report further highlights the critical need for patient involvement in the healthcare process. One of six proposed aims for improving quality of care, the "patient-centered" approach of providing care that respects and incorporates patient preferences in clinical decision making, requires adequate information, communication and education [2, 3].

The National Library of Medicine spearheads several consumer health initiatives, such as MedlinePlus, NIH Senior Health, and ClinicalTrials.gov, designed to get medical information directly into the hands of patients [4-6]. These services present one mechanism for increasing patient access to information, but do not address directly the communication between patient and provider. Information technology systems such as electronic health records and patient-focused web portals offer another mechanism for facilitating increased patient-provider communication and information sharing. Their proliferation also presents information professionals opportunities to further extend support for evidence-based medicine, consumer health and health literacy efforts directly to patients via processes that are driven by patient-specific data [7-9]. This paper reports on the Eskind Biomedical Library's (EBL) collaboration with informatics and clinical teams to foster informed patient decision-making and participatory healthcare through an online patient portal.

BACKGROUND

The Eskind Biomedical Library has a solid history of targeted, innovative provision of information services to the Vanderbilt University Medical Center (VUMC) community. The library's firm integration with the clinical and research arenas is evidenced by the success of the Informatics Consult Services; these services have brought librarianship expertise directly to the bedside and research bench since 1996 [10-12]. In 1997, with funding received from the Medical Center, the EBL introduced an Informatics Consult Service specifically designed to provide patients with health information from carefully selected resources appropriate to their education and health literacy levels. The Patient Informatics Consult Service (PICS) was designed to allow patients and patient family members to request personalized health information based on their diseases and conditions by having a Prescription for Information form completed by their physician [13].

This approach requires that patients physically enter the library, adding an extra step for individuals who may already be experiencing a great deal of stress over a medical issue. The PICS service was, in addition, never set up to reach a large number of patients and is designed to inform the patient and the treating physician on specific medical questions that need further research and in some instances further explanation. To complement this approach EBL more recently collaborated with a physician champion in an outpatient clinic to determine optimal strategies to deliver bestevidence health information to patients on a larger scale [14]. Concurrently, clinicians and software developers of the Informatics Center were engaged in the creation and refinement of a secure, interactive website specifically designed for patients which would integrate with the institution's electronic medical record system. As a unit of the Informatics Center (IC), EBL has ample opportunity to collaborate and partner with informatics colleagues in research and development initiatives that call for library expertise. When the IC initiated the clinical patient portal project, the library saw an opportunity for partnering and correcting some of the shortcomings of the previous patient information approaches, i. …