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A rapidly growing research literature documents the importance of Health IT to improve communication between health care providers and their patients. Patient Internet portals and online patient-provider communication (OPPC) allow patients to stay connected with their care providers between clinical encounters, get help and advice for their symptoms and problems from home, better understand and manage their illness, and become more engaged in their care. Through better patient-provider partnerships and communication independent of face-to-face visits, health problems and side-effects of treatment can be more easily detected, prevented, and treated more quickly.
Therefore, the overall goal of this international collaboration study is to implement and evaluate the effects and use of a primarily nurse-administered OPPC service, including access to advice from physicians and social counselors, as part of regular patient care; and using methods consistent with effectiveness research to bridge the gap between research evidence and translation into routine practice.
The specific aims of this study are twofold:
In Phase I the investigators will refine and implement an Internet-based OPPC service where patients can ask questions and receive advice and support from care providers and social counselors. The investigators will use participatory design methods to adapt an OPPC service to patients' needs; care providers' requirements; and the workflow and organizational and technical infrastructure of clinical practice by answering the following research questions:
What are the predisposing, enabling and reinforcing factors related to successful adoption, implementation and maintenance of the OPPC service such as: potential barriers to successful implementation; workflow adjustments, support and resources needed to implement and maintain the OPPC in daily clinical practice?
In Phase II the investigators will explore in a randomized, controlled trial (RCT) design the effectiveness of the OPPC service to improve patient care, and system outcomes when it is used in regular clinical practice. The control group will receive usual care; the intervention group will receive the OPPC service. Patients will be followed with 1 baseline and 4 repeated measures over 8 months. Consistent with recommendations for effectiveness trials to test an intervention under the natural conditions of routine practice, the investigators will include patients with various diagnoses from heterogeneous practice settings to increase external validity.
Research questions for Phase II are guided by the RE-AIM framework that is widely used for planning, conduct, evaluation, and reporting of intervention studies with the goal of translating research into routine practice. Its dimensions (Reach, Effectiveness, Adoption, Implementation, and Maintenance) assess the impact of an intervention and guide study designs that increase the likelihood for an intervention to work across different settings.
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
Patient's access to a practice-integrated OPPC service
Oslo University Hospital - Rikshospitalet
Published on BioPortfolio: 2014-08-27T03:19:36-0400
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