Impact of a web-based personally controlled health management system on influenza vaccination and health services utilization rates: a randomized controlled trial

J Am Med Inform Assoc. 2012 Sep-Oct;19(5):719-27. doi: 10.1136/amiajnl-2011-000433. Epub 2012 May 12.

Abstract

Objective: To assess the impact of a web-based personally controlled health management system (PCHMS) on the uptake of seasonal influenza vaccine and primary care service utilization among university students and staff.

Materials and methods: A PCHMS called Healthy.me was developed and evaluated in a 2010 CONSORT-compliant two-group (6-month waitlist vs PCHMS) parallel randomized controlled trial (RCT) (allocation ratio 1:1). The PCHMS integrated an untethered personal health record with consumer care pathways, social forums, and messaging links with a health service provider.

Results: 742 university students and staff met inclusion criteria and were randomized to a 6-month waitlist (n=372) or the PCHMS (n=370). Amongst the 470 participants eligible for primary analysis, PCHMS users were 6.7% (95% CI: 1.46 to 12.30) more likely than the waitlist to receive an influenza vaccine (waitlist: 4.9% (12/246, 95% CI 2.8 to 8.3) vs PCHMS: 11.6% (26/224, 95% CI 8.0 to 16.5); χ(2)=7.1, p=0.008). PCHMS participants were also 11.6% (95% CI 3.6 to 19.5) more likely to visit the health service provider (waitlist: 17.9% (44/246, 95% CI 13.6 to 23.2) vs PCHMS: 29.5% (66/224, 95% CI: 23.9 to 35.7); χ(2)=8.8, p=0.003). A dose-response effect was detected, where greater use of the PCHMS was associated with higher rates of vaccination (p=0.001) and health service provider visits (p=0.003).

Discussion: PCHMS can significantly increase consumer participation in preventive health activities, such as influenza vaccination.

Conclusions: Integrating a PCHMS into routine health service delivery systems appears to be an effective mechanism for enhancing consumer engagement in preventive health measures.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12610000386033. http://www.anzctr.org.au/trial_view.aspx?id=335463.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Appointments and Schedules
  • Australia
  • Electronic Health Records*
  • Female
  • Health Records, Personal*
  • Humans
  • Influenza, Human / prevention & control*
  • Internet*
  • Logistic Models
  • Male
  • Patient Acceptance of Health Care*
  • Patient Care Management / methods*
  • Preventive Health Services / organization & administration*
  • Preventive Health Services / statistics & numerical data
  • Single-Blind Method
  • Student Health Services / organization & administration
  • Student Health Services / statistics & numerical data
  • Vaccination / statistics & numerical data