ArticleBMC medical informatics and decision making2019
Evaluating the implementation of a personal health record for chronic primary and secondary care: a mixed methods approach.
Article in BMC medical informatics and decision making, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Functionalities and Issues in the Implementation of Personal Health Records: Systematic Review.Journal of medical Internet research · 2021Pooled it
- The effect of follow-up on the blood pressure control: a longitudinal study in rural areas of China.Population health metrics · 2025Article
- The State of the Art of eHealth Self-Management Interventions for People With Chronic Obstructive Pulmonary Disease: Scoping Review.Journal of medical Internet research · 2025Article
- The CeHRes Roadmap 2.0: Update of a Holistic Framework for Development, Implementation, and Evaluation of eHealth Technologies.Journal of medical Internet research · 2025Article
- Process evaluation of the implementation of the assessment of burden of chronic conditions tool in Dutch primary care - lessons from a qualitative implementation study.BMC health services research · 2024Article
- A Digital Opportunity for Patients to Manage Their Health: Turkey National Personal Health Record System (The e-Nabız)Balkan medical journal · 2023Observational
- The societal impact of implementing an at-home blood sampling device for chronic care patients: patient preferences and cost impact.BMC health services research · 2022Article
- Regional implementation of atrial fibrillation screening: benefits and pitfalls.European heart journal. Digital health · 2022Article
- Patient empowerment through a user-centered design of an electronic personal health record: a qualitative study of user requirements in chronic kidney disease.BMC medical informatics and decision making · 2021Article
- Psychometric Evaluation of the TWente Engagement with Ehealth Technologies Scale (TWEETS): Evaluation Study.Journal of medical Internet research · 2020Article
- Integrating People, Context, and Technology in the Implementation of a Web-Based Intervention in Forensic Mental Health Care: Mixed-Methods Study.Journal of medical Internet research · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPersonal health records (PHRs) provide the opportunity for self-management support, enhancing communication between patients and caregivers, and maintaining and/or improving the quality of chronic disease management. Their implementation is a multi-level and complex process, requiring a holistic approach that takes into account the technology, its users and the context of implementation. The aim of this research is to evaluate the fidelity of a PHR in chronic care (the degree to which it was implemented as intended) in order to explain the found effects.
methodsA convergent parallel mixed methods design was used, where qualitative and quantitative data were collected in parallel, analyzed separately, and finally merged. Log data of 536 users were used to gain insight into the actual long-term use of the PHR (the dose). Focus group meetings among caregivers (n = 13) were conducted to assess program differentiation (or intended use). Interviews with caregivers (n = 28) and usability tests with potential end-users (n = 13) of the PHR were used to understand the responsiveness and the differences and similarities between the intended and actual use of the PHR.
resultsThe results of the focus groups showed that services for coaching are strongly associated with monitoring health values and education. However, the PHR was not used that way during the study period. In the interviews, caregivers indicated that they were ignorant on how to deploy the PHR in current working routines. Therefore, they find it difficult to motivate their patients in using the PHR. Participants in the usability study indicate that they would value a PHR in the future, given that the usability will be improved and that the caregivers will use it in daily practice as well.
conclusionsIn this study, actual use of the PHRs by patients was influenced by the responsiveness of caregivers. This responsiveness is likely to be strongly influenced by the perceived support when defining the differentiation and delivery of the PHR. A mixed-methods approach to understand intervention fidelity was of added value in providing explanations for the found effects that could not be revealed by solely focusing on the effectiveness of the technology in an experimental trial.
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