Literature Review and Environmental Scan: Evaluation of Personal Health Records Pilots for Fee-for-Service Medicare Enrollees. Purpose of Literature Review/Environmental Scan within the Context of the ASPE Evaluation


As a preliminary step, NORC has conducted a formal literature review and environmental scan to gather, summarize and synthesize existing information relevant to key research questions for the evaluation as a whole (See Appendix A). The findings of the literature review help to define issues to be explored in greater depth during the study’s focus group and observational study components. Specifically, it is being used to develop discussion guides for focus group meetings about PHR feature usability and utility. These focus groups are tentatively scheduled to take place during the summer of 2008. The FFS PHR evaluation will be closely coordinated with an evaluation funded by CMS and Agency for Healthcare Research and Quality (AHRQ).

The CMS/AHRQ PHR evaluation will examine the use, usability, and utility of a Registration Summary/Medication History PHR tool. Seven health plans have integrated these two components into their existing PHRs and offered the PHR to Medicare Managed Care and/or Part D Drug Plan beneficiaries at no cost. Evaluation components for this project include a survey of beneficiaries who have used the PHR and focus groups with beneficiaries who either: 1) have used the PHR more than once; or 2) have decided not to register for the PHR. These focus groups will help identify factors which drive adoption of the PHR, as well as identify features and functions considered easiest to use and most useful for beneficiaries. The CMS/AHRQ evaluation team is regularly involved with the Fee-For-Service evaluation efforts, and both projects benefit from this mutual collaboration. Moreover, the literature review for this evaluation will inform later findings for both PHR evaluations by offering broad perspectives on the current PHR landscape.

Due to the potential of PHR technology to improve health care services, additional insight is needed to identify PHR features and functions that encourage PHR adoption by consumers. This review is intended to contribute to the overall development of PHRs by providing a current-state, panoramic snapshot of many key aspects of the PHR field. It offers an understanding of current knowledge of PHR usability and utility, and identifies best practices for developing PHR features and standards. At a time when PHR adoption is in its early stages, these issues are of great interest.

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