Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

What is the difference in patient engagement and clinical outcomes of using a health IT system that is designed around the patient vs just the provider - IE a shared care plan like Group Health Coo-op uses vs an EMR/PHR model?

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

Robust patient access to health IT systems that include them as a co-creator of information vs an EMR/PHR system that views them as a passive recipient of data after their care.

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

Part of the question would be to assess the demographics of who uses health IT so this would apply across all ages with a specific focus on health literacy and educational background as contributing factors.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

Those with chronic conditions vs healthy.

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Does the use of a more patient centered health IT system result in the ability to focus on those with chronic conditions. Are there secondary consequences of freeing up providers time by shifting healthy but worried well to online contact for simple questions and allowing providers to move to the medical home model as a result.

Describe any health-related risks, side effects, or harms that you are concerned about.

Does the cultural change of including patients at the design stage cause providers to balk at the entire concept of health IT. We know there is increased anxiety among providers initially (giving pts access to problem lists, abnormal labs or letting them schedule their own appts)and some providers might leave the practice entirely. Patients can be flooded with data but without information on what to do with it might become more anxious at first. There is the risk of siphoning off the healthy wealthy into botique practices that have these tools and end up creating health IT ghettos.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Cancer
• Cardiovascular disease, including stroke and hypertension
• Depression and other mental health disorders
• Diabetes mellitus
• Functional limitations and disability
• Obesity

AHRQ Priority Populations

• Low income groups
• Minority groups
• Women
• Children
• Elderly
• Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care

Federal Health Care Program

• Medicaid
• Medicare

Importance

Describe why this topic is important.

People often remember that we want to have a high quality, effective, efficient but often forget that a core goal is that it is patient centered and the ends is enfolded in the means. IE you need to include patient needs during the design stage if you want to have there needs present at the end. We are about to invst 45 billion in health IT and it is important that we start with their needs to co-create health with their providers from the beginning. Every tool and process that we develop needs to have their voice embedded in the system instead of the current strategy of viewing them as the mere recipient in 2013 of the outcome.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

People often remember that we want to have a high quality, effective, efficient but often forget that a core goal is that it is patient centered and the ends is enfolded in the means. IE you need to include patient needs during the design stage if you want to have there needs present at the end. We are about to invst 45 billion in health IT and it is important that we start with their needs to co-create health with their providers from the beginning. Every tool and process that we develop needs to have their voice embedded in the system instead of the current strategy of viewing them as the mere recipient in 2013 of the outcome.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

With over 45 billion about to be invested in health IT most of the focus remains on the technology and the data but it could also serve as a tipping point in transforming primary care practices. My overall goal it so make health care more accessible and affordable so that we no longer have to search for more resources to do more of the same but instead find ways to actually change how we deliver care so that everyone can have access to it.

Describe the timeframe in which an answer to your question is needed.

ARRA and the HITECH act are driving an entire industry to the trough and it is critical that we find a way to embed effectiveness studies into this investment. A beta project protocol could be designed within a few months.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

People in rural areas, First Nations, low income, mentally ill and the uninsured often lack access to mental health and other specialists but health IT (which includes telehealth) is one highly efficient method to reach out to them.

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

With over 45 billion about to be invested in health IT most of the focus remains on the technology and the data but it could also serve as a tipping point in transforming primary care practices. My overall goal it so make health care more accessible and affordable so that we no longer have to search for more resources to do more of the same but instead find ways to actually change how we deliver care so that everyone can have access to it.

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program

via a link on Twitter (I know how cool is that!) The link was actually broken so I searched to find it on your site.