COTS Health IT

Engaging disadvantaged patients in sharing patient generated health data and patient reported outcomes through health information technology
Patient engagement is particularly critical to achieving good chronic disease self-management. This is especially important for disadvantaged patients, who are disproportionately affected by chronic disease. A key component of chronic disease self-management is the ability for patients to record and monitor their ongoing performance on indicator measures. Patient generated health data (PGHD) can be collected through patient interaction with solutions such as mobile health apps and fitness trackers. Patient-reported outcomes (PROs) can be collected via patient response to questionnaire-based PROs measures, or PROMs. These data can be transmitted to clinical information systems, integrated into clinical workflows and used by providers to improve health care quality and delivery. While health information technology (IT) solutions have been shown to improve chronic disease self-management, adoption and use of costly, specialized technologies among disadvantaged patients is lower than among higher-income populations. In contrast, commercial off-the-shelf (COTS) technologies such as mobile phones are more accessible to and widely adopted by disadvantaged patients, thus bridging the gap of the digital divide. The central research hypothesis for this project suggests that 1) low-income, disadvantaged patients both can and will provide high-quality patient generated health data (PGHD) and patient-reported outcomes (PROs) through COTS-based health IT solutions, and 2) these data these data can be integrated into clinical systems and used to improve health care quality and delivery. This project tests the central hypothesis through three specific aims: 1) to assess the needs and preferences of disadvantaged patients and safety net health care providers regarding the use of health IT for communicating PGHD and PROs, 2) to demonstrate the feasibility of PGHD and PROs collection through COTS health IT solutions in a patient-centered pilot intervention for weight management among disadvantaged patients; and 3) to create an ontology mapping and set of interoperability resources which can be used to support the future integration of PGHD and PRO into clinical information systems.