Patient Readiness to Use Internet Health Resources
Agency for Healthcare Research and Quality
The burden of chronic disease is increasing in the United States and throughout the world. More than
100 million people in the United States live with chronic conditions, accounting for 75 percent of Medicare
spending. New approaches are needed to adequately care for people with chronic disease. One helpful
framework is the Chronic Care Model, which suggests processes and systems that can help optimize
the care of patients with chronic disease. The model emphasizes patient self-activation; activated
patients are prepared to take a collaborative, if not central, role in managing their own health.
Online health resources potentially could provide a sustainable and patient-centered format for
delivering the types of education, communication, and self-management resources needed to
optimize patient activation. Although many Web-based resources for chronically ill patients are in
development, they will only be valuable if patients have the computer skills and motivation to use them.
How prepared are such patients to use these resources? How will clinicians and patient educators judge
which patients are ready to use Web-based patient education, self-management tools, online prescription
refill requests, medication reconciliation, and secure messaging? For patients who use online health
resources, what is the relationship between motivation for behavior change and the use of these resources?
In this five-year AHRQ-funded study, we will investigate how many of our patients with chronic disease are
ready to use online health resources and engage in interactive online communication between the patient and
the health care team, with patient "readiness" comprising both aptitude and desire. However, no measure
exists to answer this question. To remedy this problem, we will develop a practical measure of the
readiness of ambulatory patients with chronic conditions to use Web-based health resources. We will test
the measure's predictive validity against logs of actual use of Web-based health resources by ambulatory
patients with chronic conditions and directly observe their use of these Web resources (Aim 1). We will
examine how use of an interactive online patient portal is associated with improvements in clinical
measures for patients with type 2 diabetes (Aim 2). This rich examination of preferences for use of
Web-based health resources among ambulatory patients with chronic disease will inform projects, systems,
and policies that seek to use the online environment as part of a comprehensive disease management
strategy. Additionally, the validated scale that we develop in Aim 1 can be added to the Health IT Survey
Compendium in AHRQ's online National Resource Center for Health IT.
For more information, contact:
Richelle Koopman, MD, MS
(Return to Current Research Projects)