Electronic health record access by patients as an indicator of information seeking and sharing for cardiovascular health promotion in social networks: Secondary analysis of a randomized clinical trial

Sherry Ann N. Brown, Hayan Jouni, Iftikhar Jan Kullo

Research output: Contribution to journalArticle

Abstract

We investigated electronic health record (EHR) access as an indicator of cardiovascular health promotion by patients in their social networks, by identifying individuals who viewed their coronary heart disease (CHD) risk information in the EHR and shared this information in their social networks among various spheres of influence. In a secondary analysis of the Myocardial Infarction Genes trial, Olmsted County MN residents (2013–2015; n = 203; whites, ages 45–65 years) at intermediate CHD risk were randomized to receive their conventional risk score (CRS; based on traditional risk factors) alone or also their genetic risk score (GRS; based on 28 genomic variants). We assessed self-reported and objectively quantified EHR access via a patient portal at three and six months after risk disclosure, and determined whether this differed by GRS disclosure. Data were analyzed using logistic regression and adjusted for sociodemographic characteristics, family history, and baseline CRS/GRS. Self-reported EHR access to view CHD risk information was associated with a high frequency of objectively quantified EHR access (71(10) versus 37(5) logins; P = 0.0025) and a high likelihood of encouraging others to be screened for their CHD risk (OR 2.936, CI 1.443–5.973, P = 0.0030), compared to the absence of self-reported EHR access to view CHD risk information. We thereby used EHR access trends to identify individuals who may function as disseminators of CHD risk information in social networks, compared to individuals on the periphery of their social networks who did not exhibit this behavior. Partnering with such individuals could amplify CHD health promotion. Clinical Trial Registration: Myocardial Infarction Genes (MI-GENES) Study, NCT01936675, https://clinicaltrials.gov/ct2/show/NCT01936675.

Original languageEnglish (US)
Pages (from-to)306-313
Number of pages8
JournalPreventive Medicine Reports
Volume13
DOIs
StatePublished - Mar 1 2019

Fingerprint

Information Dissemination
Electronic Health Records
Health Promotion
Social Support
Randomized Controlled Trials
Coronary Disease
Disclosure
Myocardial Infarction
Genes
Logistic Models
Clinical Trials

Keywords

  • Behavior modification
  • Electronic health records
  • Genetics
  • Patient engagement
  • Patient portals
  • Personal health records
  • Risk assessment
  • Risk factors
  • Social network

ASJC Scopus subject areas

  • Health Informatics
  • Public Health, Environmental and Occupational Health

Cite this

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title = "Electronic health record access by patients as an indicator of information seeking and sharing for cardiovascular health promotion in social networks: Secondary analysis of a randomized clinical trial",
abstract = "We investigated electronic health record (EHR) access as an indicator of cardiovascular health promotion by patients in their social networks, by identifying individuals who viewed their coronary heart disease (CHD) risk information in the EHR and shared this information in their social networks among various spheres of influence. In a secondary analysis of the Myocardial Infarction Genes trial, Olmsted County MN residents (2013–2015; n = 203; whites, ages 45–65 years) at intermediate CHD risk were randomized to receive their conventional risk score (CRS; based on traditional risk factors) alone or also their genetic risk score (GRS; based on 28 genomic variants). We assessed self-reported and objectively quantified EHR access via a patient portal at three and six months after risk disclosure, and determined whether this differed by GRS disclosure. Data were analyzed using logistic regression and adjusted for sociodemographic characteristics, family history, and baseline CRS/GRS. Self-reported EHR access to view CHD risk information was associated with a high frequency of objectively quantified EHR access (71(10) versus 37(5) logins; P = 0.0025) and a high likelihood of encouraging others to be screened for their CHD risk (OR 2.936, CI 1.443–5.973, P = 0.0030), compared to the absence of self-reported EHR access to view CHD risk information. We thereby used EHR access trends to identify individuals who may function as disseminators of CHD risk information in social networks, compared to individuals on the periphery of their social networks who did not exhibit this behavior. Partnering with such individuals could amplify CHD health promotion. Clinical Trial Registration: Myocardial Infarction Genes (MI-GENES) Study, NCT01936675, https://clinicaltrials.gov/ct2/show/NCT01936675.",
keywords = "Behavior modification, Electronic health records, Genetics, Patient engagement, Patient portals, Personal health records, Risk assessment, Risk factors, Social network",
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