Health Information Rx Pilot Health Information Rx Pilot

National Library of Medicine

American College of Physicians Foundation

December 17, 2003

Project GoalsProject Goals

• Educate and support physicians in referring their patients to MEDLINEplus for health information Increase physician awareness Support referral process by providing

resource materials

• Test Information Rx in IA and GA

Project GoalsProject Goals

• Evaluate change in physician awareness resource materials use of MEDLINEplus by patients

ApproachApproach

Project materials• Centerpiece is customized Rx pad• Posters, bookmarks, patient card

Letter and response card Mailing to librarians Evaluation

• Special urls to topic pages• Email address for patient feedback• Pre and Post-project questionnaires

Health Information PrescriptionHealth Information PrescriptionPartners: American College of PhysiciansAmerican Society of Internal Medicine Foundation

Prescription PadPrescription Pad

ParticipantsParticipants

• 517 physicians 398 Georgia 119 Iowa

• Launches March/April

Health Information Rx Pre-Pilot Health Information Rx Pre-Pilot Email UseEmail Use

44%

21%

35%

No and won't start

No but might start

Yes

n = 525

Do you currently communicate with your patient via email?

Patient Education Pre-Pilot Patient Education Pre-Pilot Resources UsedResources Used

27%

54%

89%

58%

32%

ACP-ASIM Pamphlets

Internet Sites

Pharm Mfg Pamphets

Practice Developed Materials

Education Organization Pamphlets

n = 511

Which of the following types of patient education resources do you use in your office?

Health Information Rx Pre-Pilot Health Information Rx Pre-Pilot Website ReferralsWebsite Referrals

1.00%

13%

21%

19%

27%

33%

44%

45%

48%

3%

14%

CDC

NIH

Local Hospital Websites

ACP Online

Arthritis Foundation

MEDLINEplus

Mayo Clinic

Amer Cancer Soc

Amer Heart Assn

Amer Diabetes Assn

WebMD

n = 308

To which of the following Internet sites do you refer your patients?

Websites to Which Patients Are Referred: Websites to Which Patients Are Referred: Percent Ranked 1Percent Ranked 1stst or 2 or 2ndnd Out of 5 Out of 5

Post-PilotPost-Pilot

10%

4%

6%

7%

12%

54%

5%

5%

9%

9%

9%

23%

16%

3%

3%

2%

3%

2%

5%

2%

Other

Local hospital sites

Arthritis Foundation

Amer Cancer Soc

Mayo

AHA

ACP Online

Amer Diabetes Assoc

WebMD

MEDLINEplus

Ranked 1st

Ranked 2nd

n = 216

70%

35%

16%

15%

14%

7%

5%

5%

8%

15%

Change in Number of Patient Change in Number of Patient Referrals to Internet Referrals to Internet

No Change46%

Increased54%

Decreased0%

n = 210

Since participating in Information Rx Pilot, has the percentage of patients you refer to the Internetfor information increased, decreased, or not changed?

Reasons Patients Are Reasons Patients Are Not Referred to InternetNot Referred to Internet

5%

6%

16%

31%

35%

55%

61%

74%

3%

7%

19%

29%

19%

18%

71%

84%

Other

Might reduce compliance

Too much time to explain

Might increase anxiety

Unreliable websites

Lack appropriate websites

Lack cognitive skill

No computer access

Post (n=201)

Pre (n=521)

Please indicate your reasons for not referring patients to the Internet for health information.

Perceived Benefits of Referring Perceived Benefits of Referring Patients to MEDLINEplusPatients to MEDLINEplus

19%

22%

35%

37%

42%

43%

54%

No perceivedbenefits

Reduce Anxiety

Reduce time onpt education

Encouragecompliance

Improvecommunication

Explain difficultconcepts

Promote patientself-efficacy

In what ways has your practice benefited by your referring patients to MEDLINEplus?

n = 196

Agreement that MEDLINEplusAgreement that MEDLINEplus “Improves Patient Understanding of “Improves Patient Understanding of

Difficult Concepts/Procedures”Difficult Concepts/Procedures”

4%

33%

9%

54%

0%

Strongly Disagree

Disagree

Neither agree nordisagree

Agree

Strongly Agree

MEDLINEplus improves a patient’s understanding of difficult concepts and procedures

n = 210

Incidence of Referring Patients to Public Incidence of Referring Patients to Public Library for Health InformationLibrary for Health Information

No73%

Yes27%

Do you refer your patients to the local library for health information?

n = 208

12%

41%

46%

Not at all

Somewhat

Very Much So

Would it increase your willingness to refer patients to MEDLINEplus if local libraries provided free access to the Internet … and assistance in locating health information?

n = 209

Impact of Local Library Support on Impact of Local Library Support on Willingness to Refer Patients to Willingness to Refer Patients to

MEDLINEplusMEDLINEplus

Health Information Referral Pilot Health Information Referral Pilot Resource UseResource Use

17%

39%

59%

26%

45%

MEDLINEplus CD

Health RecordCards

Bookmarks

Examining RoomPosters

InformationPrescription Pads

n = 216

Which of the following resources have you used?

Additional Physician FeedbackAdditional Physician Feedback

• Focus discussions in GA Very positive Site easy to use Simplify Rx pad Basic info about site for patients Need email reminders Advertise directly to patients

Additional Physician FeedbackAdditional Physician Feedback

• Telephone interviews Rated program 4.4 on 5 point scale Rx pad most used item Suggestions for improvement indicate

more education needed Want email reminders

Patient FeedbackPatient Feedback

• Survey on ACP site Few filled out; unanimous praise

• URL counts small

• Exploring other ways to get feedback

Next Steps?Next Steps?

• Expand to Virginia in January

• Revise materials

• More patient feedback

• Media

• Involve libraries

• More information and periodic email reminders